Determinants of sexual and reproductive health service utilization among youth in Amudat Town Council, Amudat District, Uganda

Abstract

Introduction: Adolescence is a period of great changes that requires societal support as adolescents and youths often engage in risky sexual behavior that often results in adverse health, social and economic consequences. Such enhanced health risks require that they easily access SRH services to achieve a healthy transition to adulthood; yet despite such need, they do not to use the SRH services. Understanding reasons for non-use of the SRH services require contextual understanding, yet few studies have focused on hard-to-reach areas. This study sought to assess determinants of SRH utilization among youth in Amudat Town Council, Amudat District. Methods: This was an analytical cross-sectional study employing quantitative and qualitative data collection and analysis approaches. Data was collected from both random and purposively selected participants in June 2018 using interviewer administered questionnaires, Key Informant Interviews and Focus Group Discussions. Results: A total of 503 youth were interviewed. The mean age of the respondents was about 21 years with mean age at first marriage at 18 years. More than half of the respondents, 66.7% (336/503) had ever had a sexual and reproductive health problem among whom the majority 95.2% (320/336) had sought SRH services from a qualified health service provider. Respondents in the age group 20-24 years were 10 percent (APR=0.90, CI=0.83-0.97, p=0.01) more likely to utilize SRH services compared to their counterparts aged 15-19 years old. Students were less likely to utilize SRH services compared to other respondents (APR=1.12, CI=1.01-1.26, p=0.03) and respondents who were not in school had visited a health facility to utilize SRH services more than those in-school (APR=1.12, CI=0.91-1.37, p=0.03. Also, it was found that youth who did not agree that religion approves youth to seek SRH services had 5% less chances of having utilized SRH services (APR=0.95, CI=0.91-0.99, p=0.003) and respondents who did not agree that contraceptives encourages promiscuity were less likely to have visited the health facility to utilize SRH service (APR=0.95, CI=0.91-0.99, p-value=0.03). Conclusions: Utilization of SRH services by the youth can be increased by offering integrated SRH outreach services, training health workers in youth friendly SRH services delivery, reaching youth gatekeepers with accurate SRH information, fostering family values that favor open discussions on SRH, promoting girl child education, preventing child marriage, providing accessible and affordable quality government SRH services that address drug stock outs, offer variety of services, and provide knowledge on where to access what services.